8/21 Sparky AMPS 370

[Aly & Sparky]

Haven't posted in a few days, so I'm not linking to yesterday.

I did create a spreadsheet and i TRIED to post it to my signature, let me know if you can see it! **I wasn't able to use the template- i kept getting an error message so i created a similar one that i think is easy to read.

So don't kill me, but it turns out that first dose I accidently shot 5.0 instead of 0.5 (i'm such an idiot!!) I was so nervous from not shooting for 6 years I have no idea what happened with that and I'm so glad Sparky is okay. I already spent a few days beating myself up about it so please be kind.

So I've actually been shooting 0.5 units for 4 shots now. All his preshots are up in the 300s and the +3 I took today was 309.

I'm thinking about increasing his dose to 1.0. I'm going to try to get more spot checks though.

Again, I'm not familiar with Lantus like I was PZI, so let me know if an increase to 1.0 sounds acceptable, I would like to get him regulated and pretty tightly if possible.

 

[Aly & Sparky]

AMPS 370 +3 308 +6 340

Not doing much for us, and I'm sure I shot well under the skin. 2.0u excessive? Thoughts anyone? To early to tell?

 

[Marje and Gracie]

Aly:

I don't think I've been on your condo yet....sorry. But welcome to lantus land.

A few things:
1. we don't dose based on the PS like you would with PZI. We dose based on the nadir with "some" consideration given to PS.

2. I'm sorry to say but you aren't getting in enough tests for us to know what he is doing...esp at night. We recommend that you get in the habit of getting at least a +2 and a pre bed-time test or an "out the door" test if it's daytime to see what he is doing. With lantus, high numbers can indicate a "bounce" where he might be going low at night and then the liver is releasing counterregulatory hormones which drive the BG up. Bounces can take up to six cycles (72 hours) to clear. Without more testing, we're not sure exactly what he's doing BUT see "3" below.

3. He hypoed after the 5.0 units with a BG of 28 the next morning. I think you are still seeing a bounce from that very low number. I would not change his dose until he has the opportunity to clear that bounce. Six cycles from the "28" would be tomorrow morning so I wouldn't increase until tomorrow night IF his numbers stay high. I'd be sure and let us know what he's doing tomorrow so we can help you with a dose.

3. When we increase, we typically do it in amounts of .25u if nadirs are between 200-300. But that's only if it is a true nadir and not a bounce. Please do not increase him at this time and please never increase him more than .25u unless his nadirs when he is not bouncing are greater than 300.

I think it's important to read the protocol again....it's alot of info and so it takes some time to absorb. Here's just a summary to backup the info I've given you this morning:

"General" Guidelines:
•Hold the initial starting dose for 5 - 7 days (10 - 14 consecutive cycles) unless the numbers tell you otherwise. Kitties experiencing high flat curves or prone to ketones may want to increase the starting dose after 3 days (6 consecutive cycles).
•Each subsequent dose is held for a minimum of 3 days (6 consecutive cycles) unless kitty earns a reduction (See: Reducing the dose...).
•Adjustments to dose are based on nadirs with only some consideration given to preshot numbers.
Increasing the dose:
•Hold the dose for 3 - 5 days (6 - 10 consecutive cycles) if nadirs are less than 200 before increasing the dose.
•After 3 days (6 consecutive cycles)... if nadirs are greater than 200, but less than 300 increase the dose by 0.25 unit.
•After 3 days (6 consecutive cycles)... if nadirs are greater than 300 increase the dose by 0.5 unit.

Here's the link to the protocol:
Tight Regulation Protocol

I did look at your SS and it works for now but it would be helpful to try and get the regular one working because it is set up so that the numbers are keyed into a specific color which makes reviewing the SS much easier. Tech Support can help you with that.

Remember that lantus takes patience; as I have told others ...it's a marathon not a sprint. Let's see where he is tomorrow and if he clears the bounce.

 

[Lisa and Do Lou (GA)]

Just stopping by to say Hello to you Sparky ;-)

 

[Aly & Sparky]

Thanks for the valuable info. I still have to read up on "Condos" and work on using the correct spreadsheet, as well as absorbing all the information on Lantus. And I apologize for seeing quick answers instead of researching. I'm juggling working with my 6 year old bean, 4 year old bean, and 6 week old bean. That's a lot of beans ;-)

I'll keep him at .5 and try to get more spot checks in the meantime. THANKS for the help!

 

[Marje and Gracie]

Yes you do have your hands full!!!! Well.....we are here to answer your questions so, considering your time constraints, best to ask before you take any action on changing doses AND absolutely on low numbers.